Comparative Politics of Health: Popular Demands, Institutional Legacies

Session Submission Type: Full Paper Panel

Session Description

This panel mobilizes tools and concepts from comparative politics research in developing countries to explore cross-national differences and similarities in health and health-policy outcomes. Delving into the complex politics of wellbeing in low- and middle-income countries (LMICs) shows both how existing theories provide explanatory power and are challenged by application in the health sphere. Populism and privilege are at the root of key dilemmas in health and healthcare in these contexts. Expectations rise along with GDP and connection to global communications, challenging underdeveloped and inequitable health systems, often designed to serve privileged ruling classes, to increase provision of health-related public goods. In some sense LMICs present a contrast with recent manifestations of populism in advanced industrialized countries—experienced less as a backlash against immigration or taxation than as a dynamic contestation around the mechanisms through which the broader population will draw aid and protection from the state. Health and healthcare are central. Populism and privilege take on a different light when geopolitical positionality is considered in the health politics of LMICs, where the interests of international global health agencies, international financial institution pressure, and post-colonial legacies are often decisive factors in national responses to diseases and health challenges. State capacity and corruption feature heavily in health politics as do the influences of powerful cultural actors. Exploring the ideas, institutions, and actors in health reveal important insights about the broader political economy of development. In particular this panel includes attention to rising middle-income countries where struggles over the role of the private sector, multi-level governance, and technological advance all interact with rising incomes and contestation around healthcare access and equity. Our four papers take up the task of bringing global health and comparative politics together. Prerna Singh brings key insights about “embedded” institutions to look at how the popular uptake of new health technologies differs in India and China, based on the frame and authority of communication about that technology. Claudio Méndez, Scott Greer and Miguel Saavedra look at how institutional legacies in the centralized, segmentalist Chilean system structure efforts to provide popular, universal guarantees to healthcare access for the broader public and consider how models built for European contexts travel to Latin America. Michael Gusmano explores the complexity of how democracy itself generates health outcomes through a comparison of access to health care in the so-called BRIC nations (Brazil, Russian, India and China). Mark Daku argues for the importance of an historical institutionalist approach to understanding how politics and health interact through a comparison of the initial responses to HIV/AIDS in South Africa and Uganda.

Sub Unit

• DIVISION 12: Comparative Politics in Developing Countries

Individual Presentations

• Legacies of Centralism: Governance Challenges for Health & Health Care in Chile - Claudio A. Méndez, Universidad Austral de Chile; Scott L. Greer, University of Michigan

• The Control of Contagion: Ideas, Institutions & Disease in China and India  - Prerna Singh, Brown University

• Democracy and Population Health: Lessons from the BRICs - Michael K. Gusmano, The Hastings Center

• A More Political Epidemiology: Historical Institutionalism & Population Health - Mark Daku, Texas Christian University

Chair

• Matthew Kavanagh Georgetown University

Discussant

• Kim Yi Dionne University of California, Riverside